GROWTH IN INFANTS WITH BRONCHOPULMONARY DYSPLASIA AFTER INITIAL HOSPITAL DISCHARGE. 1595

Abstract

Bronchopulmonary Dysplasia (BPD) is often associated with long term growth problems. This study was designed to examine current rates of growth failure in infants with BPD and to prospectively determine risk factors associated with growth failure. After initial hospital discharge, the growth of 40 infants with mean gestational age of 27 ± 2 weeks, was followed with 7 monthly home visits. Potential risk factors included, low energy intake, feeding problems, difficult temperament, low socioeconomic status (SES), post discharge illness/hospitalization, and compromised caregiver-infant feeding relationship. Z score differences were calculated between the first visit and the last visit. Twenty nine infants (73%) experienced a drop in weight for age Z score, and 8 infants (20%) experienced a drop in height for age Z score. Risk of growth failure, defined as weight or length less than the 5th percentile at the last visit and experienced by 18 (45%) infants, was increased by low socioeconomic status (RR 2.13, 95% CI 1.04,4.33), significant feeding difficulties (RR 2.33, 95% CI 1.24,4.38), and difficult temperament(RR 2.08, 95% CI 1.04,4.19). Problems associated with feeding were common and included choking, coughing, cyanosis, crying, and fatigue. Infants with growth failure were more likely to have a “suspect” finding on the Denver II (Chi square 6.05, p=0.014). Growth failure and feeding problems continue to be a problem for infants with BPD. We found that growth was adversely affected by low socioeconomic status, feeding difficulties, and difficult temperament. High risk infants may benefit from frequent nutrition assessment and intervention for feeding problems.